K Number
K061864
Device Name
DUKAL SURGICAL FACE MASK TIE-ON, MODEL 1530; EAR LOOP, MODEL 1540; WITH SHIELD, MODEL 1560
Manufacturer
Date Cleared
2006-09-15

(74 days)

Product Code
Regulation Number
878.4040
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Dukal medical / surgical masks are indicated as a protective nose and mouth covering for healthcare workers and patients involved in medical and surgical procedures. The masks are indicated in any procedure or situation where there is a risk of microorganism, body fluid and particulate aerosol transfer.
Device Description
Dukal Surgical Masks are pleated 3 – ply masks. Inner and outer layers are made of either medical grade tissue or 100% spun-bond polypropylene. Middle layer is made of 100% melt blown polypropylene filter. Ear loops are made of soft latex free elastic loops. The nose piece for all Dukal Masks is a malleable aluminum wire. Masks with splash visors have an anti fog treated plastic shield attached to masks. All of the material used in the construction of the Dukal face masks are being used in currently marketed devices (see predicate information)
More Information

No
The device description and performance studies focus on the physical properties and filtration capabilities of a surgical mask, with no mention of AI or ML technology.

No.
The device's intended use is for protection and prevention of microorganism, body fluid, and particulate transfer, not for treating any medical condition or disease.

No

Explanation: The device is a medical/surgical mask, which serves as a protective barrier to prevent the transfer of microorganisms, body fluids, and particulate aerosols. Its purpose is protective, not diagnostic.

No

The device description clearly outlines physical components like layers of material, ear loops, and a nose piece, indicating it is a physical medical device, not software-only.

Based on the provided information, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The intended use is to act as a physical barrier to prevent the transfer of microorganisms, body fluids, and particulate aerosols between healthcare workers, patients, and the environment during medical and surgical procedures. This is a physical barrier function, not a diagnostic one.
  • Device Description: The description details the physical construction of the mask (layers, materials, ear loops, nose piece). There is no mention of reagents, assays, or any components designed to analyze biological samples.
  • Performance Studies: The performance studies focus on the physical barrier properties of the mask (fluid resistance, filtration efficiency, breathability, flammability). These are relevant to a protective barrier device, not an IVD.
  • Lack of IVD Characteristics: There is no mention of analyzing biological samples (blood, urine, tissue, etc.), detecting specific analytes, or providing diagnostic information about a patient's health status.

IVD devices are used to examine specimens derived from the human body to provide information for diagnostic, monitoring, or compatibility purposes. This mask does not perform any of these functions.

N/A

Intended Use / Indications for Use

The Dukal medical / surgical masks are indicated as a protective nose and mouth covering for healthcare workers and patients involved in medical and surgical procedures. The masks are indicated in any procedure or situation where there is a risk of microorganism, body fluid and particulate aerosol transfer.

Product codes

FXX

Device Description

Dukal Surgical Masks are pleated 3 – ply masks. Inner and outer layers are made of either medical grade tissue or 100% spun-bond polypropylene. Middle layer is made of 100% melt blown polypropylene filter. Ear loops are made of soft latex free elastic loops. The nose piece for all Dukal Masks is a malleable aluminum wire. Masks with splash visors have an anti fog treated plastic shield attached to masks. All of the material used in the construction of the Dukal face masks are being used in currently marketed devices (see predicate information)

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Nose and mouth

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Healthcare workers and patients involved in medical and surgical procedures.

Description of the training set, sample size, data source, and annotation protocol

Not Found

Description of the test set, sample size, data source, and annotation protocol

Not Found

Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

Performance Characteristics:

  • Fluid Resistance Performance (mmHg): ASTM F1862-05 Pressure at 80mm Hg. Dukal: 30 out of 32 passed. Medicom K051291: 19 out of 32 passed.
  • Particulate Filtration Efficiency Performance (%): ASTM2299. Dukal: 98.3%. Medicom K051291: 98.7%.
  • Bacterial Filtration Efficiency Performance (%): ASTM F2101-01 ASTM F2100-04. Dukal: 99.9%. Medicom K051291: 99.8%.
  • Differential Pressure (Delta-P) (mmH2O/cm2): ASTM F2101-01 MIL-M-36945C 4.4.1.1.1 Method 1. Dukal: 2.28 (ave) mmH2O/cm². Medicom K051291: 2.28 (ave) mmH2O/cm².
  • Flammability class 1: ASTM F2101-01 MIL-M-36945C 4.4.1.1.1 Method 1. Dukal: No Flame Spread Class 1. Medicom K051291: No Flame Spread Class 1.

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s)

K051291, K040333

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc)

Not Found

§ 878.4040 Surgical apparel.

(a)
Identification. Surgical apparel are devices that are intended to be worn by operating room personnel during surgical procedures to protect both the surgical patient and the operating room personnel from transfer of microorganisms, body fluids, and particulate material. Examples include surgical caps, hoods, masks, gowns, operating room shoes and shoe covers, and isolation masks and gowns. Surgical suits and dresses, commonly known as scrub suits, are excluded.(b)
Classification. (1) Class II (special controls) for surgical gowns and surgical masks. A surgical N95 respirator or N95 filtering facepiece respirator is not exempt if it is intended to prevent specific diseases or infections, or it is labeled or otherwise represented as filtering surgical smoke or plumes, filtering specific amounts of viruses or bacteria, reducing the amount of and/or killing viruses, bacteria, or fungi, or affecting allergenicity, or it contains coating technologies unrelated to filtration (e.g., to reduce and or kill microorganisms). Surgical N95 respirators and N95 filtering facepiece respirators are exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to § 878.9, and the following conditions for exemption:(i) The user contacting components of the device must be demonstrated to be biocompatible.
(ii) Analysis and nonclinical testing must:
(A) Characterize flammability and be demonstrated to be appropriate for the intended environment of use; and
(B) Demonstrate the ability of the device to resist penetration by fluids, such as blood and body fluids, at a velocity consistent with the intended use of the device.
(iii) NIOSH approved under its regulation.
(2) Class I (general controls) for surgical apparel other than surgical gowns and surgical masks. The class I device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to § 878.9.

0

K061864

510(k) Summary

SEP 1 8 2006

Device Trade Name: Non Sterile Surgical Mask

Name and Address of Manufacturer: Dukal Corporation 5 Plant Ave Hauppauge, NY 11788

Establishment Registration: 2435946

Contact Person: Patrick J. Lamb Vice President International Operations 5 Plant Ave. Hauppauge, NY 11788

Device Classification Name: Mask, Surgical

Classification Panel: Class II, §878.4040

Classification Advisory Committee: General and Plastic Surgery

Product Code: FXX

Recognized Performance Standard:

ASTM 2100-04 Refer to submission for applicable standards

Predicate Devices

  • 510(k) Number 1. A.R. Medicom K051291
  1. ValuMax International (K040333

1

K061864

.

| Intended Use: | The Dukal medical / surgical masks are indicated as a
protective nose and mouth covering for healthcare workers
and patients involved in medical and surgical procedures.
The masks are indicated in any procedure or situation
where there is a risk of microorganism, body fluid and
particulate aerosol transfer. |
|-------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| 510(k) Statement: | A 510(k) statement for this device, as required by 21 CFR 93, is
replaced with this 510(k) summary. |
| Truthful and Accurate
Statement: | A Truthful and accurate statement as required by 21 CFR
§807.87(j) may be found in the submission in Exhibit A |
| Labeling: | Samples of proposed labeling may be found in the submission in
Exhibit B |
| Device Description: | Dukal Surgical Masks are pleated 3 – ply masks. Inner and
outer layers are made of either medical grade tissue or
100% spun-bond polypropylene. Middle layer is made of
100% melt blown polypropylene filter. Ear loops
are made of soft latex free elastic loops. The nose piece for
all Dukal Masks is a malleable aluminum wire. Masks with splash
visors have an anti fog treated plastic shield attached to masks. All
of the material used in the construction of the Dukal face
masks are being used in currently marketed devices (see
predicate information) |

:

2

: : :

ItemTest MethodDukalMedicom K051291
Inner LayerRaw material
Specifications100% Spun-bond
polypropylene
or medical grade
tissue (25 gsm)Same
Outer LayerRaw material
Specifications100% Spun-bond
polypropylene or
medical grade
tissue (16gsm)100% Spun-bond
polypropylene or medical
grade tissue (14gsm)
Middle LayerRaw material
Specifications100% melt blown
polypropylene
filter media
(25 gsm)Same
Ear LoopRaw material
SpecificationsSoft latex free
elastic loops and
ties
(40 gsm)Latex Free Elastic Loops
and ties
38 gsm
Nose PieceRaw material
SpecificationsMalleable
aluminum wiresame
Plastic ShieldRaw material
SpecificationsATFF-High
Impact 0.10mmsame
Fluid
Resistance
Performance
(mmHg)ASTM F1862-05
Pressure at 80mm
Hg30 out of 32
passed19 out of 32 passed
Particulate
Filtration
Efficiency
Performance
(%)ASTM229998.3%98.7%
Bacterial
Filtration
Efficiency
Performance
(%)ASTM F2101-01
ASTM F2100-0499.9%99.8%
ItemTestDukalMedicom K051291
Differential Pressure
(Delta-P)
(mmH20/cm2)ASTM F2101-01
MIL-M-36945C
4.4.1.1.1 Method 12.28 (ave)
mmH2O/cm²2.28 (ave)
mmH2O/cm²
Flammability class
1ASTM F2101-01
MIL-M-36945C
4.4.1.1.1 Method 1No Flame Spread
Class 1No Flame Spread
Class 1
Mask StylesTie, Ear Loop and
mask with fluid
shieldTie, Ear Loop and
mask with fluid
shield
ColorBlueBlue
Layers33

Performance Characteristics

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K061864

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Performace Characterics, con't

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Public Health Service

Image /page/4/Picture/2 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized caduceus, which is a symbol often associated with medicine and healthcare. The words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" are arranged in a circular pattern around the caduceus.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

SEP 1 8 2006

Mr. Patrick J. Lamb Vice President International Operations Dukal Corporation 5 Plant Avenue Hauppauge, New York 11788

Re: K061864

Trade/Device Name: Dukal Surgical Face Masks Regulation Number: 21 CFR 878.4040 Regulation Name: Surgical Apparel Regulatory Class: II Product Code: FXX Dated: August 18, 2006 Received: September 13, 2006

Dear Mr. Lamb:

We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to such additional controls. Existing major regulations affecting vour device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

5

Page 2 - Mr. Lamb

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); good manufacturing practice requirements as set forth in the quality systems (OS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

This letter will allow you to begin marketing your device as described in your Section 510(k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and thus, permits your device to proceed to the market.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Office of Compliance at (240) 276-0115. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). You may obtain other general information on your responsibilities under the Act from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number (800) 638-2041 or (240) 276-3150 or at its Internet address http://www.fda.gov/cdrh/industry/support/index.html.

Sincerely yours,

Clara

Chiu Lin. Ph.D. Director Division of Anesthesiology, General Hospital, Infection Control and Dental Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

6

Indications for Use

510(k) Number (if